COPD - Looking for pulmonologist recommendations

My dad is 76 and has been battling COPD for quite some time now, and honestly, even with the diagnosis, he just hasn't been able to kick the smoking habit. He’s been on Spiriva Respimat, and for the longest time, things were actually looking pretty steady—he could even tackle uphill walks without breaking much of a sweat.

Lately, though, he’s really struggling to catch his breath and gets wiped out almost instantly from the slightest bit of exertion. He actually went ahead and saw a cardiologist on his own because he was worried it might be a heart issue, but they gave him the all-clear and said his heart is perfectly healthy.

So, I’ve got two questions for you guys:

1. Does anyone have a great pulmonologist they’d recommend? We’re based over in Cleveland, so local is better, but we’d definitely consider driving out to Washington, D.C. if the specialist is worth it.

2. Is there a chance his situation is extremely critical right now, or is it a good sign—which is what I’m telling myself to stay positive—that since he hasn't needed oxygen therapy yet, it means things aren't at their absolute worst? I've been reading that oxygen is usually reserved for the most severe cases, so I'm hoping that means he can still maintain some semblance of a normal life for a while longer once we get the right treatment dialed in.

copperrider59 said:My father is 76 and has been battling COPD for quite some time. Even with the diagnosis, he hasn't been able to quit smoking. He was using Spiriva Respimat, and for a long while, his condition stayed relatively stable... he could still walk uphill without much trouble...

Is there any chance this is an extreme emergency? I keep telling myself that since he hasn't needed oxygen therapy yet—and I've read that oxygen is usually reserved for the most critical cases—it means things aren't at their absolute worst. Maybe with oxygen support, he’ll be able to function somewhat normally for a little while longer...

Hi, I can't really recommend a specific pulmonologist in Washington, D.C. or Cleveland... I can only say from my mother's experience that COPD is a progressive disease that goes through different stages...
The goal is to preserve quality of life as much as possible... and to slow down the progression...

A pulmonologist needs to monitor the situation to determine which of the four stages applies. From there, they can decide if long-term oxygen therapy is necessary. With daily, at-home oxygen support, it's possible to function relatively normally for years... 😉

Restrictions will show up eventually, though how much they affect you is probably different for everyone. My mom struggled with more lung issues during her own battle... since no two cases of COPD are exactly the same, it's probably best not to make direct comparisons...

He definitely needs to get that spirometry done, along with whatever other tests the specialist orders. There are standard protocols in place, so I don't think there's much room for error...

Over time, they'll become more sensitive to colds and things like that... which could lead to flare-ups...

It’s possible they might just add an extra layer to his treatment, like a new inhaler or some nebulizer sessions... that could make all the difference...

Look into pulmonary rehab... learn some breathing exercises and how to pace yourself properly when you get winded. A pulmonologist can show you specific techniques. It would be good to walk on flat ground to stay active, maybe grab some 1 lb weights to do some light daily exercises along with the breathing work. Even just using your arms helps maintain muscle mass... that affects oxygen intake. This disease tends to cause muscle loss over time, so we need to slow that down. Diet is just as important too...

If he ramps up the therapy and starts on corticosteroids, he really needs to stay out of the sun while taking them... It’s also vital to use supplements to support the immune system. The prognosis looks better with regular Vitamin D—especially since older patients have a harder time synthesizing it naturally, so he definitely needs it. Vitamin C is a must, along with other vitamins and minerals based on his specific needs and his doctor's advice...

Probiotics are worth considering. Gut health plays such a huge role in immunity and lung function...

It would be so much better if they could just quit smoking, but I know at that age, it’s already such a hard habit to break...

Changes in altitude and regular trips to a wellness retreat... it all impacts quality of life and can either help slow down progression or speed it up...

Keep an eye on his phlegm. If you notice any color changes, like a greenish tint or anything unusual, you should have it analyzed. He might need antibiotics or something else if it turns out to be a fungal issue... He might have just caught a stronger cold. Over time, he’ll likely become more sensitive to colds and seasonal shifts. It all plays a part, so it's important to monitor everything and get him the right treatment...

I think you'd see it too—that things have taken a turn for the worse and need immediate medical attention... It's best to get to a pulmonologist as soon as possible...

I just want him to recover and feel better soon...

My father was just diagnosed with early-stage COPD, but he was in really bad shape when it happened. After dealing with severe bronchitis and part of a pneumonia last year, he had basically lost all his strength... and he's already 85.

On top of everything else, I've been having him take royal jelly, and it honestly worked wonders to get him back on his feet. He regained so much energy...

Honey, honey with propolis, or royal jelly (as long as there aren't any allergies)—you can never have too much of that. He takes it constantly, and it helps him clear out everything he's coughing up quite easily.

Petrovic Apitherapy makes some excellent blends. My mother used to take them (I don't live in the US), so I'd definitely recommend them as extra support. But most importantly, he needs to see a specialist to get the right medical treatment...

So we just got back from the pulmonologist—he ran a spirometry test, did a Ventolin test (it came back negative, which I guess means the Ventolin isn't really doing much for him), and took some chest X-rays.

The official diagnosis is Stage III B COPD with bullous emphysema.

He was prescribed an antibiotic called Hiriacim, and instead of using Spiriva, he’s switching over to a new med called Spiriva Respimat. He'll just use the Ventolin as needed now. And obviously, the doctor gave him the whole "you absolutely have to quit smoking" speech.

Honestly, it's wild because even on the very first day after using the Spiriva Respimat, he was already feeling way better, so it looks like that specific medication is a total winner for him. Plus, he actually quit smoking!

I'm glad you took that crucial step and he started his new treatment, especially since he’s already feeling some relief.

It matters that you've done everything possible to stabilize things now and slow down the progression as much as you can moving forward.
I'm not sure what the previous diagnosis was, but it sounds like a new phase has hit where emphysema is complicating the COPD, which is a direct result of smoking—so major props to him for quitting! It's a massive hurdle for long-term smokers, but such a huge win for managing the disease and keeping his quality of life up.

Yes, it's vital that he takes the Spiriva Respimat at the same time every day to keep those airways open. We don't have that specific brand here in the States, but we use similar things like Spiriva, though from what I can see, Spiriva Respimat is a more advanced version...

This isn't necessarily the time of year when the disease itself flares up like it does in the spring, but it is a season of vulnerability—colds, the risk of the flu (he definitely needs his shot), and so on. Around here, doctors usually prescribe antibiotics as soon as even a minor cold sets in for someone with this diagnosis, which is good for preventing more serious infections.

It's great that he's seeing improvements right away. There are so many different types of inhalers, solutions, and therapies available, especially if he stops responding to Ventolin (it didn't work for my mom, but she had asthma on top of everything else, so her regimen was more intense)... there are plenty of options.

Changes like this can be pretty stressful 😉 But you, your father, and the whole family are all just learning how to adapt and live with this as best as you can. You're doing everything right, and things should feel more stable now 😉

And I'd recommend staying hydrated. Drinking plenty of water helps with quitting smoking, and it's generally helpful for COPD and making it easier to clear the lungs...

Yeah, back when I had my initial checkup—like, four years ago now—it was just listed as KOBP-GOLD B

Seriously, thanks a ton for all the advice and the support!

Following a hospitalization for COPD, the patient was prescribed a tapering course of Medrol: 16 mg for seven days, followed by 8 mg for seven days, and finally 4 mg every other day.

I understand this schedule is intended to gradually reduce the dosage before discontinuing the medication entirely.

My question is: how long should one continue taking the 4 mg dose every other day? This specific detail was unfortunately omitted from the discharge papers provided by the hospital.

If you really want the most accurate answer, you need to take this exact same question directly to one of the doctors who was actually overseeing your father’s care. I know, I know—there are all these general guidelines and standard protocols out there, but let's be real: at the end of the day, the only person who can give you a definitive, precise answer is the specialist who actually prescribed the treatment plan in the first place.